
| Name | Value |
|---|---|
| NAME | HOSE ANTI-EMBOLISM KNEE LEN XX-LRG-REG |
| VA GENERIC NAME | HOSE |
| DOSAGE FORM | STOCKING |
| NATIONAL FORMULARY NAME | HOSE STOCKING |
| CREATE DEFAULT POSSIBLE DOSAGE | YES |
| CODING SYSTEM |
|
| COPAY TIER |
|
| PGX ELIGIBLE | NO |
| PGX SUPPRESSED | NO |
| VA PRINT NAME | HOSE ANTI-EMBOLISM KNEE LEN XX-LRG-REG |
| VA PRODUCT IDENTIFIER | XZ204 |
| TRANSMIT TO CMOP | YES |
| VA DISPENSE UNIT | PR |
| MASTER ENTRY FOR VUID | YES |
| VUID | 4015552 |
| EFFECTIVE DATE/TIME |
|